L-R: N&N consultant Bijan Beigi with Michael Kneale and his father David Kneale. Picture submitted by Norfolk and Norwich University Hospitals NHS Foundation Trust.

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Last June Michael Kneale, of Bradwell, noticed that his vision had become blurry.

His father David, an optometrist, found that Mr Kneale had gone colour-blind in one eye and was suffering from a form of optic nerve defect.

Mr Kneale was urgently referred to the James Paget Hospital in Gorleston by his GP, where an MRI scan identified that a tumour behind his right eye was pressing dangerously against his optic nerve.

While the tumour was benign (non-cancerous), it was known as an ‘ossifying fibroma’ which was growing rapidly.

Due to the location of the tumour it became necessary to draw on the expertise of specialist surgeons from both the Paget and the Norfolk and Norwich University Hospital (N&N).

The two surgeons, the Paget’s Carl Philpott and N&N’s Bijan Beigi, described the tumour as “extremely rare and particularly precarious” due to its position behind the eye.

By October Mr Kneale’s right eye was visibly protruding as the tumour had grown to golf-ball size and threatened to make him blind.

But the surgeons still had to work out how to remove the growth without causing permanent damage to Mr Kneale’s eye.

Finally, after a tense five-hour operation in which the surgeons knew any mistake could damage Mr Kneale’s sight, they successfully removed his tumour.

He spent two more days in hospital before discharge, and is now enjoying life as normal.

“It’s been such a whirlwind and it’s nice to be able to relax after everything that has happened,” Mr Kneale said.

“I knew I was in good hands and now I’m feeling really well.”

His father David added: “We’re absolutely delighted with the result of the operation.

“It’s just mind-boggling. It was such a nerve-wracking prospect but we knew there was no option but to remove the tumour as Michael would have lost his sight.”

Mr Philpott said: “It was an excellent demonstration of how resources between trusts, specialties, and colleagues can be harnessed for the greater good and I hope we are able to continue this fruitful collaboration.”

How the operation was carried out

The two surgeons decided to reach the tumour by inserting an endoscope through Mr Kneale’s nose.

An incision was then made on the upper eyelid crease of the right eye to reach part of the tumour from another angle.

The depth of the tumour and its proximity to the optic nerve, which transmits impulses to the brain, meant the surgical team had to work within the finest of margins to prevent lasting damage being caused to the eye.

During the operation a navigation system used an electromagnetic field to track the surgical instruments, in order for surgeons to make sure they were being precise enough.

This navigation system enabled the team to identify the exact location of the tumour, the medical instruments, and the surrounding tissues.

The surgeons managed to remove the whole tumour, and finally a small synthetic implant was secured between the tumour space and the eye to prevent the eye socket from collapsing.

Mr Beigi said: “Bringing our skills together as specialist consultants and utilising state-of-the-art technology to support treatment has delivered an excellent result for our patient.

“I’m so pleased that Michael is recovering well and look forward to working with Mr Philpott and his team in the future.”